Women’s Health Newsletter
November 2014
In This Edition Did You Know ICD-10 Cutover Testing Event Clarity Project
FetaLink+ Conversions Advocate Health Care
FAQ Signal Quality Alert
What We're Doing Postpartum Hemorrhage
All About Physician Handoff
Women’s Health Newsletter On the Cover Landon James Choate This month’s cover baby is Landon James Choate.
His mom is Cerner Associate Kristen Choate, Sr. Team Lead with the Women’s Health Consulting team.
Did You Know ICD-10 Cutover Testing Event During the week of September 29 - October 3, 2014, Cerner’s Regulatory Compliance Practice Team, along with 17 solution teams, held a free remotehosted ICD-10 Cutover Testing Event. With 38 clients and 28 CommunityWorks clients registered to participate, our primary goal was to increase client’s readiness for the transition from ICD-9 to ICD-10. On October 1, 2015, every health care provider will face this steep challenge of transition to ICD-10. Performing a thorough test during our cutover event and relevant post compliance scenarios is the only true way to know if they are ready. By choosing to participate in this event, we enabled our clients to discover issues they might encounter when transitioning to ICD-10. During the event a total of 72 SRs were logged and all solution teams did an outstanding job of providing support. Of these issues, none were critical. Common issues that were seen applied to PowerChart Ambulatory, Scheduling, and Cerner HIM Solution. We further broke down these issues into three categories:
Domain Issues - issues related to simulating domain to mirror October 1, 2015
Education Issues - issues understanding the cutover steps or execution of the cutover steps
ICD-10 Issues - ICD-10 cutover issues that clients have encountered related to the cutover
Our testing event was a valuable opportunity for clients because it gave them a chance to get direct involvement with people who will have cutover tasks to execute the night of the ICD-10 transition. Clients have already expressed their satisfaction and feel better prepared for the October 1, 2015 transition.
We are already glad that we chose to participate in this event – and we are only about 1/2 of the way finished. –Ken, NASH_NC
The ICD-10 mock cutover event has raised my confidence in our ability to be prepared for ICD-10 considerably. – John, RUTL_VT
November 2014
Did You Know continued As the transition to ICD-10 progresses, the ICD-10 Regulatory Compliance Practice team will continually make sure that our clients are ready for the transition. By providing optimal service and testing events to our clients we believe that they will be entirely ready for the October 1, 2015 deadline. With continued support our team will be hosting another free ICD-10 Cutover Testing Event in Q1 of 2015. If you have questions about our event or would like to learn more about our upcoming event, please email the CRC@cerner.com inbox.
Technical Corner Millennium Downtime Mode
The FetaLink Technical Blog is now available on the Women’s Health Collaboration Community uCern group! The current topic is “What does the FetaLink message for Millennium Downtime Mode mean?”
Clarity Project Cerner strives to provide you the best possible service experience by answering questions and addressing concerns quickly and accurately. In an effort to enhance your overall support experience, we have added a prompt to our automated system. Beginning on October 20, 2014, when you call the main Cerner line, you will have the opportunity to enter a Universal Ticket Number (also known as a Service Request number). The system will route your call directly to the ticket owner. If he or she is unavailable, your call will automatically go to someone on that specific team who can provide details or an update on your request. This new feature will get you to the right resource and responsible team more quickly.
This blog is not meant to replace official FetaLink documentation and training. Rather, this blog will serve as an additional resource meant to offer our assistance with various
Note that for all critical support needs, you should continue to contact Cerner’s Immediate Response Center (IRC).
FetaLink topics.
Women’s Health Newsletter Ideas Space As of October 17, 2014, Cerner made process changes to our Ideas collaborative model. These changes include:
The lifecycle of an idea will no longer be fixed (3 +/- month timeframe) – it will be open-
FetaLink+ Conversions Advocate Health Care We are pleased to announce the successful conversion of FetaLink+ at Advocate Health Care in Chicago, Illinois. Advocate Illinois Masonic Medical Center and Advocate Good Shepherd Hospital went live on October 21st and October 23rd respectively. Advocate Good Shepherd Hospital handles 1300 births per year and moved from a legacy mobile fetal monitoring system to FetaLink+, while Advocate Illinois Masonic Medical Center averages 2700 births per year. OB physicians from both facilities will benefit greatly from the remote viewing capabilities that FetaLink+ provides.
Advocate Illinois Masonic Medical Center
ended. This means all feasible ideas will remain “Open for Discussion,” allowing more time for collaboration and review of the idea.
Ideas will no longer be declined based strictly on fixed lifecycle deadlines.
As Ideas continue to grow at a rate of 100-200 per week, Cerner will commit to triage all ideas;
Advocate Good Shepherd Hospital
November 2014
FAQ Signal Quality Alert
The FetaLink Signal Quality Alert is an option for sites on FetaLink version 2013.01 or higher. If enabled, the Signal Quality Alert will display an icon and a border color change to indicate that FetaLink is receiving a low signal quality event from the fetal monitor device.
Ideas Space continued
however we can no longer commit to “respond” to all
A low signal quality event happens whenever the fetal monitor device cannot trace a continuous fetal heart rate signal, such as when the fetus moves away from the transducer. Once FetaLink begins to receive a good quality signal again, the Signal Quality Alert will auto-cancel.
ideas. Further dialog with the
By filtering out results that could be considered “nuisance” alerts and by not producing an audible chime, Signal Quality Alert can greatly reduce alert fatigue.
not occur until more interest in
Although clinicians want to know when the signal quality is low so they can make necessary adjustments, they understand that losing the FHR signal is commonplace and requires a different kind of response than the true out-of-range alerts. Without Signal Quality Alert enabled, the FetaLink system will alert with the red border and the audible chime whenever it receives a result that is out-of-range, even if it is due to a low signal quality.
logger from Cerner will typically
the idea is generated, or if the idea is immediately identified as one aligned with our roadmap.
Olmstead Medical Center was a testing partner for the Signal Quality Alert code. Since November 2013, they have experienced a decrease in the number of alerts. These changes will continue to provide clients with the collaborative, transparent experience around enhancements to our solutions allowing Cerner to more actively engage with our clients. “Nursing staff are no longer alert fatigued. We know when the alarm goes off it needs immediate attention” said Brandy Claffy, RN, of Olmstead Medical Center. “Less time spent on (nuisance) alarms means more time spent with our patients.” For more details on this new alert, please refer to the Design Alerts reference page.
Women’s Health Newsletter Save The Date FetaLink+ Demo
What We're Doing Postpartum Hemorrhage by Jessica Alford If you were to talk to any health care provider who cares for laboring patients about postpartum hemorrhage, not only will they all know what it is, but they will all also more than likely have their own stories about patients they have cared for that had life-threatening or life-ending complications related to Postpartum Hemorrhage (PPH). PPH is on the rise globally, and one of the most striking things about PPH is that it is affecting both developed and underdeveloped nations. This fact alone may contribute to why it is such a hot topic and such a focus in the Women’s Health space.
Please join Women’s Health Senior Strategist Jill Meier and Solution Designer Greg Kuttenkuler on Tuesday, December 16, at 12:00 CST as they share the latest updates to our mobile fetal monitoring solution, FetaLink+.
Watch the Women’s Health Collaboration Community uCern group for more details in the coming weeks.
Most of the recommendations for prevention and treatment of PPH are very similar. The initial recommendations include assessing more frequently for the specific risk factors associated with PPH. These assessments should occur on admission or during the initial phases of labor; Intrapartum, when the patient is approximately 8-10 cm dilated; and Postpartum. Depending on the risk factors identified during the assessment, the patient will be classified into a risk category. Each risk category will also have additional recommended tasks to be done based upon the risk category that the patient gets placed into from the assessment. Secondary recommendations include the active management of the third stage of labor. This management would include administration of uterotonic agents, controlled cord traction, and uterine massage after delivery of the placenta if needed. Other recommendations include evaluating the cause of the PPH (evaluating the 4 T’s), which could include the Tone of the uterus, Trauma to the uterus, cervix or vagina, retained Tissue, and Thrombin issues. Once the cause is determined, then the most appropriate plan of action can be developed. There are many recommendations to ensure the safest care for patients that are at risk for postpartum hemorrhage, as well as recommendations to manage postpartum hemorrhage. However, just imagine what would happen if PowerChart Maternity could help with the identification and management of postpartum hemorrhage in the maternal population. Our plan is to sort through the data within the chart simultaneously as patient care is performed to find risk factors that have been documented on the patient throughout the pregnancy, or even throughout their entire history of medical care that has been documented within the Cerner system. The solution could provide reminders to do the risk assessments for postpartum hemorrhage in the event that not all of the data would be fully captured in the medical record based upon site configuration.
November 2014
What We're Doing continued The risk factors would be quickly identified by the solution and displayed to the user in a way that would support the workflow and alert them to the potential changes in the patient’s status. If at any time the risk factors are modified or additional ones are added, the solution would alert the user the patient’s risk status has changed and provide decision support as to what additional tasks need to be performed in order to better prepare for a postpartum hemorrhage. The management phase of a postpartum hemorrhage could also be supported in PowerChart Maternity by plans of care that would recommend treatment based upon the risk assessment status of the patient. The electronic medical record (EMR) would inform the providers of changes in the patient’s risk status, as well as changes in the patient’s condition, including keeping the provider apprised of trending in the lab values. The capabilities of PowerChart Maternity to gather all of this data simultaneously with the bedside patient care enable the best of both worlds. Caregivers can still practice medicine at the bedside and care for their patients, but none of the risk factors would get overlooked. Additionally, when the risk factors are all collected and management is recommended, the providers could have the ability to adjust the recommendations in the alert instead of going outside of the workflow to alter the recommendations for that specific patient. The overall goal of the EMR is to be the source of truth for the patient’s lifelong medical history. The beauty of the data capture is the ability to data mine the information to enable better care of the patient. The data can also be extracted from the system for reporting purposes, whether to be submitted to regulatory agencies, or to be tracked for improvement goals of the unit, hospital, or health system. In my experience as a former labor and delivery nurse, the ability to have the EMR help me to keep track of all of the risk factors that the patient might have throughout her medical history would have definitely made a difference in the preparedness of all of the medical professionals involved in the patient’s care. I can only imagine as I think back over my career, how much my patient’s lives were altered by the unexpected result of a postpartum hemorrhage. Having a brand new baby can be life-changing all by itself. If we can help our patients’ transition seamlessly instead of recovering slowly from low Hemoglobin/Hematocrit results, receiving blood transfusions, being admitted to the ICU without their newborn infants, having interventional radiology procedures, undergoing hysterectomies or worse, why would we not utilize PowerChart Maternity to help? We are working on this solution for you to help with the safety of your patients! Stay tuned for more updates as we make progress in getting this out to you for your use!
Maintaining Industry Awareness World Prematurity Day
World Prematurity Day is observed on November 17th each year to raise awareness of preterm birth and the concerns of preterm babies and their families worldwide. Approximately 15 million babies are born preterm each year, accounting for about one in 10 of all babies born worldwide. Find the Global Action Report here.
Women’s Health Newsletter Content Suggestions
All About
The Women’s Health team under-
A recent study done at Boston’s Children Hospital measured the benefits of IPASS, an electronic physician hand-off tool. It revealed marked improvements in physician communications. (Article is cited in JAMA December 4, 2013, Volume 310, Number 21, pages 2262 – 2270). The study was launched to address a leading cause of medical errors – the patient transition of care process. By focusing on the physician handoff process, Boston’s Children Hospital significantly decreased medical errors, as well as preventable adverse events, for their hospitalized children. In addition to seeing a reduced error rate, the hand-off improved verbal and written communications within the physician teams.
stands your time is valuable and we want to ensure you are receiving benefit from this newsletter.
We would love to hear about topics you would like to see covered in future issues.
Physician Handoff
The focus of the Physician Handoff is to provide a standardized transfer of care – improving both communication and patient safety. The acronym for the IPASS approach is the following: I - Illness Severity P – Patient Summary A - Action List S – Situational Awareness S – Synthesis by Receiver
Please send your topic suggestions to WomensHealth@Cerner.com
We look forward to hearing from you!
Cerner offers the Physician Handoff within the PowerChart license. It is launched from the organizer toolbar and opens to a customized care team and/or individual provider inpatient list with the patient’s room number, age, sex, illness severity, primary contact and diagnosis.
November 2014
All About continued By selecting the arrow to the right of the patient’s name, the provider can see in detail the pertinent information for the transfer of care using the IPASS method. Additional information such as length of stay, active diagnosis and procedures for the current encounter can be viewed.
SIG Co-Chairs We Need You! Angie and Susan will be completing their 2-year terms as Co-Chairs of your Women’s Health Special Interest Group (SIG) and have done a remarkable job! The end of 2014 will be here before we know it and there will be an opportunity for new Co-Chairs to take on the duties and responsibilities that Susan and Angie have performed. One of the main activities of the SIG Chair is to guide agenda development and coordination for our quarterly meetings. If you are interested in becoming a
In addition to the IPASS tab, there are additional tabs containing information. The second tab, labeled Clinical Data, allows for review of all labs and medications ordered for the patient within the last 24 hours.
Co-Chair, please contact Jill Meier.
Women’s Health Newsletter All About continued
November 2014
Social Media Become a member of our Women’s Health Collaboration Community on uCern. uCern is a great way to stay up to date on the latest developments around PowerChart Maternity and FetaLink, hear about upcoming events, network and share tips and tricks with your peers.
The final tab lists the clinical team for the patient, along with contact information.
If you are not already a member, we hope you’ll sign up soon!
Join us on Facebook
Join us on uCern
For additional information about how to configure the physician handoff for PowerChart Maternity, please refer to the Women’s Health Physician Specialty playbook.
If you are interested in printing this newsletter, you can download a printable PDF on our Women’s Health Collaboration Community uCern page.